26 Chapter 2 Medical photographs were taken within the first postoperative year in 13 out of 30 patients (43%) and in three out of ten patients (30%) in the displacement and replacement group, respectively (P=0.456). Global aesthetic judgment scores distributed in the categories poor, fair, good and excellent are summarized in Table 3. The median scores by the specialists and laymen for global aesthetic judgment, symmetry of the breast, scarring, and areola-nipple symmetry are presented in Table 4. Table 3. Individual global aesthetic judgment scores, categorized as poor, fair, good and excellent, by patients and panel. Patient (n=50) Plastic surgeon 1 (n=40) Plastic surgeon 2 (n=40) Laymen 1 (n=40) Laymen 2 (n=40) Poor 2 (4.0) 3 (7.5) 2 (5.0) 5 (12.5) 10 (25.0) Fair 5 (10.0) 6 (15.0) 7 (17.5) 11 (27.5) 5 (12.5) Good 18 (36.0) 21 (52.5) 19 (47.5) 17 (42.5) 14 (35.0) Excellent 25 (50.0) 10 (25.0) 12 (30.0) 7 (17.5) 11 (27.5) Data are n (%). Table 4. Cosmetic outcomes for patients, plastic surgeons and laymen in the four categories. Total Volume replacement Volume displacement P-value Patient Global aesthetic judgment Symmetry Scar Areola-nipple symmetry* N=50 3.50 (3.00-4.00) 2.50 (1.00-4.00) 3.00 (3.00-4.00) 3.00 (2.50-4.00) N=12 3.00 (3.00-4.00) 3.00 (2.00-4.00) 3.00 (2.00-4.00) 4.00 (2.50-4.00) N=38 4.00 (3.00-4.00) 2.00 (1.00-3.00) 4.00 (3.00-4.00) 3.00 (2.00-4.00) 0.500 0.246 0.120 0.379 Specialist Global aesthetic judgment Symmetry Scar Areola-nipple symmetry** N=40 3.00 (2.50-3.50) 2.50 (2.00-3.00) 3.00 (3.00-3.50) 3.00 (2.50-3.50) N=10 3.00 (2.50-3.50) 3.00 (2.50-3.50) 3.00 (3.00-4.00) 3.50 (3.00-4.00) N=30 3.00 (2.50-3.50) 2.50 (2.00-3.00) 3.00 (3.00-3.50) 3.00 (2.50-3.50) 1.000 0.020 0.939 0.053 Laymen Global aesthetic judgment Symmetry Scar Areola-nipple symmetry** N=40 2.75 (2.00-3.50) 2.50 (1.00-3.00) 3.00 (2.00-3.50) 2.75 (2.00-3.50) N=10 2.75 (2.00-3.50) 3.00 (2.50-3.50) 2.25 (1.50-3.00) 3.00 (2.50-3.50) N=30 2.75 (2.00-3.50) 1.75 (1.00-3.00) 3.00 (2.00-3.50) 2.50 (2.00-3.50) 0.866 0.031 0.221 0.241 Numbers are median (IQR). For areola-nipple symmetry, numbers are lower than mentioned in the ‘total’ column because of exclusion criteria. *47 patients, 12 volume replacement, 35 volume displacement. ** 36 patients, 10 volume replacement and 26 volume displacement. Significant P-values are depicted in italic.
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